A Sengstaken-Blakemore tube is used in emergency situations to control bleeding from fragile veins in the wall of the esophagus. It can stabilize the patient while care providers develop a plan for addressing the bleeding in the long term. Tube placement can be complicated, and typically requires heavy sedation for the patient because it is uncomfortable. After approximately 24 to 36 hours, it will be necessary to remove the device and implement a more permanent solution.
Patients with esophageal varices, swollen and fragile veins in the esophagus, can develop bleeds that are very difficult to control. If they report for treatment, care providers may try medication, positioning, and other tools to stop the bleeding. In the event this doesn’t work, a Sengstaken-Blakemore tube may be proposed as a temporary treatment. Several similar products are also available and may be recommended if a care provider prefers them.
The device includes a hollow tip inserted into the stomach, attached to a balloon. A second balloon is located partway up the tube. This design allows a care provider to insert the Sengstaken-Blakemore tube, aspirate the contents of the stomach through the hollow tip, and inflate the lower gastric balloon to control the bleeding. The second balloon, positioned in the esophagus, can also be inflated if this appears to be necessary.
Before placement o fa Sengstaken-Blakemore tube, the patient may be positioned with care and sedated for comfort. Technicians can hold the patient during placement to reduce the risk of injury. Some care providers like to place a tracheal tube to secure the airway. This ensures that the Sengstaken-Blakemore tube is not accidentally placed in the wrong location. Alternatively, the medical team may consider a Minnesota tube, which has a similar design with an added port to suction the esophagus, which reduces the risk of aspirating its contents.
Once the tube is in place to control the bleeding and the patient’s immediate needs are met, the team can discuss the next option. Surgery may be necessary, along with other treatment options, to manage the varices. Long-term control of the condition that caused the problem in the first place may also be a topic of discussion, as care providers do not want patients to experience repeat episodes of esophageal bleeding. If a patient has varices because of chronic acid reflux, for example, the doctor may wish to discuss how to control the condition to protect the esophagus.